Online Forms

 Dr. Clemons offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

Intake Form

Download & Print Form


Acknowledgement of Receipt of Notice of Privacy Practices

Download & Print Form


Consent To Treat

Download & Print Form


Patient Demographic Form

Download & Print Form


Download the Free Adobe Reader®

Locations

Find us on the map

Office Hours

Our Regular Schedule

Primary Office

Monday:

9:00 am-3:00 pm

Tuesday:

9:00 am-5:30 pm

Wednesday:

9:00 am-3:00 pm

Thursday:

9:00 am-5:30 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed